​Writing Exercises for People with Parkinson’s Disease

​Singapore General Hospital (SGH) Occupational Therapy Department shares simple writing exercises for people with Parkinson’s disease to help them improve their handwriting.

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 PEOPLE WITH PARKINSON’S DISEASE

​need to put in extra effort to write in a manner that is closer to their normal size as the condition causes their writing to appear small and crowded.

​Handwriting exercises for people with Parkinson’s

People with Parkinson’s disease (Parkinson’s for short) may find themselves having difficulty with writing and signature. This can be distressing for many who take pride in their handwriting. People with Parkinson’s may find their writing becoming smaller and crowded together as they write (Micrographia).

The small handwriting are a result of the stiffness and slowness of movements commonly seen in people with Parkinson’s.  When a person with Parkinson’s tries to write in their usual way, the writing may turn out small and cramped.

To produce better writing, people with Parkinson’s must think about making their writing bigger than their usual writing. The extra effort will produce writing which is closer to their normal size.

How to do handwriting exercises for Parkinson’s

Here’s a warm-up routine to practice just before you sit down to write:

  1. Hold a pen and imagine you are writing in the air. Make the writing as BIG as possible, then try to make it even BIGGER. You can sign your name, write numbers or draw a picture. Just make it BIG. Use a window or mirror frame to help you keep the letters big. Do this for 2-3 minutes.
  2. Shake out your arms and hands to loosen up the muscles and get them ready for writing. Roll your shoulders forwards and backwards 5 times each. Flick your hands and fingers as if you are shaking water off them 10 times. Make sure to open your fingers completely.
  3. Make BIG scribbles and lines on a piece of scrap paper. Make sure to reach all the corners of the paper.
  4. Practice these patterns. Start from the centre () and make each circle bigger than the one before.

Some hand and finger exercises you can do to keep your fingers nimble:

  1. Hold a pen between your fingers and thumb, and ‘walk’ your fingers up to the top and back down. Do this with BIG movements of the fingers and thumb.
  2. Practice copying these hand signs moving slowly and straightening your fingers completely (these show the right hand)

Other suggestions to improve handwriting for people with Parkinson:

  • Use wide ruled lined paper as a visual reminder to keep all letters big when writing. When practicing, make your letters big enough to touch the top and bottom line.
  • Practice makes perfect! Write one page every day.
  • Sit in a comfortable chair, and write on a table. Place your entire forearm up to the elbow on the table if you need more support e.g. if there are tremors.  Use a clipboard or a non-slip mat to stop your paper slipping.
  • Write during “on” time when medication is working best.
  • Take breaks as needed, especially when your hand begins to feel sore or when your handwriting is getting smaller. Repeat the warm-up exercises as often as you need.
  • Use a pen with a non-slip grip or a larger sized pen to help you get a better grip. Pens with a barrel that is not round (e.g. triangular) may also be easier to grip

Alternatives to writing include:

  • Typing
  • Speech to text software or features which are now available on most computers and smartphones

You can consult an occupational therapist to provide individual recommendations for concerns about handwriting.

This information was provided by the Singapore General Hospital (SGH) ​Occupational Therapy Department, a member of the SingHealth group.

Ref: K21

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